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儿童牙痛正成为众人关切之事:在英国伦敦,当孩子口腔疼痛时家长该何去何从?一项横断面分析。

Children's toothache is becoming everybody's business: where do parents go when their children have oral pain in London, England? A cross-sectional analysis.

作者信息

Muirhead Vanessa Elaine, Quayyum Zahidul, Markey Donal, Weston-Price Sally, Kimber Annette, Rouse Wayne, Pine Cynthia M

机构信息

Centre for Dental Public Health and Primary Care, Institute of Dentistry, Queen Mary University of London, London, UK.

Centre for Primary Care and Public Health, Blizard Institute, Queen Mary University of London, London, UK.

出版信息

BMJ Open. 2018 Feb 28;8(2):e020771. doi: 10.1136/bmjopen-2017-020771.

Abstract

OBJECTIVES

To assess the number of parents who visited community pharmacies in London seeking pain medications for their children's pain and specifically for oral pain, to identify which health services parents contacted before their pharmacy visit and to estimate the cost to the National Health Service (NHS) when children with oral pain who visit pharmacies also see health professionals outside dentistry.

DESIGN

A cross-sectional study.

SETTING

1862 pharmacies in London in November 2016-January 2017.

PARTICIPANTS

Parents, carers and adolescents purchasing over-the-counter pain medications or collecting pain prescriptions for children (0-19 years).

BRIEF INTERVENTION

A survey administered by pharmacy staff to participants and a guidance pack.

MAIN OUTCOME MEASURES

The number of parents who visited pharmacies seeking pain medications for their children's pain and oral pain and the number of parents who contacted health professionals outside dentistry before their pharmacy visit. Estimated costs of visits by children with oral pain to health professionals outside dentistry.

RESULTS

One in two (951) pharmacies participated collecting information from 6915 parents seeking pain medications for their children. The majority (65%) of parents sought pain medications to relieve their children's oral pain. Only 30% of children with oral pain had seen a dentist before the pharmacy visit, while 28% of children had seen between one and four different health professionals. The cost to the NHS of children contacting health professionals outside dentistry was £36 573, extrapolated to an annual cost of £373 288. Replicating these findings across all pharmacies in England could mean that the NHS spends an estimated £2.3 million annually when children with oral pain inappropriately use multiple health services.

CONCLUSION

Most parents who visited pharmacies for children's pain medications in London sought pain medications for children's oral pain. Children's inappropriate contact with multiple health services when they have oral pain adds significant costs to the NHS.

摘要

目的

评估在伦敦社区药房为孩子疼痛(特别是口腔疼痛)寻求止痛药物的家长数量,确定家长在前往药房就诊前联系了哪些医疗服务,并估算口腔疼痛儿童在前往药房就诊时还寻求牙科以外医疗专业人员诊治的情况下,英国国家医疗服务体系(NHS)的成本。

设计

横断面研究。

地点

2016年11月至2017年1月期间伦敦的1862家药房。

参与者

为0至19岁儿童购买非处方止痛药物或领取止痛处方的家长、照料者及青少年。

简要干预

药房工作人员对参与者进行的一项调查及一份指导手册。

主要观察指标

为孩子疼痛(特别是口腔疼痛)前往药房寻求止痛药物的家长数量,以及在前往药房就诊前联系牙科以外医疗专业人员的家长数量。估算口腔疼痛儿童前往牙科以外医疗专业人员处就诊的费用。

结果

二分之一(951家)药房参与了研究,收集了6915位为孩子寻求止痛药物的家长的信息。大多数(65%)家长寻求止痛药物以缓解孩子的口腔疼痛。只有30%口腔疼痛儿童在前往药房就诊前看过牙医,而28%的儿童看过1至4位不同的医疗专业人员。NHS为儿童联系牙科以外医疗专业人员的成本为36573英镑,推算出的年度成本为373288英镑。在英格兰所有药房推广这些研究结果可能意味着,当口腔疼痛儿童不恰当地使用多种医疗服务时,NHS每年估计花费230万英镑。

结论

在伦敦,大多数为孩子疼痛前往药房寻求止痛药物的家长是为孩子的口腔疼痛寻求药物。儿童口腔疼痛时不恰当地联系多种医疗服务给NHS增加了巨大成本。

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